What causes dry eyes?

Eye dryness is a common malady that results from aging effects on the lacrimal glands that produce tears. The eye dryness may be relieved by the use of artificial tears which can be bought over-the-counter at most stores. If there is no relief from artificial tears, a visit to your physician is recommended to discover both the cause and treatment of dry eyes.

Causes of dry eyes can include sun exposure, wind exposure, cold air exposure, exposure to smoke, antihistamines, eye injury, Sjogren’s syndrome and eye surgery. If left untreated, dry eyes may cause tiny abrasions on the surface of the eyes.

Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected. This is especially true after menopause.

Dry eye can also be associated with other problems. For example, people with dry eyes, dry mouth and arthritis are said to have Sjögren’s syndrome. (For more information on Sjögren’s syndrome, see the “resource” section of this handout.)

People with similar systemic diseases like lupus, rheumatoid arthritis or some types of thyroid disease will often have dry eye.

A wide variety of common medications — both prescription and over-the-counter — can cause dry eye by reducing tear secretion.

Be sure to tell your ophthalmologist (Eye M.D.) the names of all the medications you are taking, especially if you are using:

• Diuretics for high blood pressure
• Beta-blockers for heart or high blood pressure
• Antihistamines for allergies
• Sleeping pills
• Medications for “nerves”
• Pain relievers

Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with eyedrops called artificial tears.

People with dry eye are often more prone to the toxic side effects of eye medications, including artificial tears. For example, the preservatives in certain eyedrops and artificial tear preparations can irritate the eye. These people may need special, preservative- free artificial tears.

Normally, the eye constantly bathes itself in tears. By producing tears at slow and steady rates, the eye stays moist and comfortable. Sometimes people do not produce enough tears or the appropriate quality of tears to keep their eyes healthy and comfortable. The condition is called dry eye. Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected. This is especially true after menopause. A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers, or wind. Smoking is especially bothersome.

The usual symptoms of dry eye include:

-- Stinging or burning eyes;
-- Scratchiness;
-- Stringy mucus in or around the eyes;
-- Excessive eye irritation from smoke or wind;
-- Excess tearing;
-- Discomfort when wearing contact lenses.

If you are suffering from any of these symptoms, you should see an eye doctor, who can talk to you about potential treatments to relieve some of these symptoms.

Dry eye syndrome most often occurs when the tear film (the mixture of salt water, oils from melbomian glands in the lids, and dissolved mucins from conjunctival tissue glands that coat the eye surface) is disrupted or compromised. The problem usually involves many factors, including excessive evaporation and other disruptions.

Although our tear glands tend to produce fewer tears naturally as we get older, this condition is not exclusively a problem of the elderly. Other factors, such as prolonged wearing of contact lenses, lasik surgery, lack of humidity in the air (often from heating and air conditioning), frequent air travel, and too much time spent in front of computer screens contribute significantly to this condition.

Sometimes, other disorders or diseases, including infections, conjunctivitis, allergies, or more serious conditions such as the autoimmune disorder Sjogrens Syndrome, sarcoidosis, and diabetes contribute to dry eyes. Certain medications can also lead to or aggravate the condition, including antidepressants and antihistamines.

Even though you're not crying all the time, you need to continuously produce tears to protect your eyes and help keep them comfortable. A decrease in normal tear production or an interruption in the distribution of your tears can lead to dry eyes.

A decrease in tear production may occur as a natural part of aging and is particularly common among postmenopausal women. Or it could be due to other reasons, such as allergies, dry weather, cosmetics, or contact lenses. Eyes can also feel dry when tears are not distributed well, such as when you stare at a computer screen for long hours without blinking often. The result is eyes that burn, sting, or feel scratchy, tired, or strained.

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